[1]王蓉,邓应平.水液缺乏型干眼和混合型干眼患者睑板腺形态及功能差异[J].眼科新进展,2021,41(8):783-785.[doi:10.13389/j.cnki.rao.2021.0163]
 WANG Rong,DENG Yingping.Morphologic and functional differences of meibomian gland in patients with aqueous-deficient dry eyes and mixed dry eyes[J].Recent Advances in Ophthalmology,2021,41(8):783-785.[doi:10.13389/j.cnki.rao.2021.0163]
点击复制

水液缺乏型干眼和混合型干眼患者睑板腺形态及功能差异/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年8期
页码:
783-785
栏目:
应用研究
出版日期:
2021-08-05

文章信息/Info

Title:
Morphologic and functional differences of meibomian gland in patients with aqueous-deficient dry eyes and mixed dry eyes
作者:
王蓉邓应平
610200 四川省成都市,成都市第七人民医院眼科(王蓉);610041 四川省成都市,四川大学华西临床医学院(王蓉);610041 四川省成都市,四川大学华西医院眼科(邓应平)
Author(s):
WANG Rong12DENG Yingping3
1.Department of Ophthalmology, the Seventh People’s Hospital of Chengdu, Chengdu 610200, Sichuan Province, China
2.West China Medical School of Sichuan University, Chengdu 610041, Sichuan Province, China
3.Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
关键词:
水液缺乏型干眼睑板腺功能障碍混合型干眼眼表面干涉仪
Keywords:
aqueous-deficient dry eyes meibomian gland dysfunction mixed dry eyes LipiView
分类号:
R777.2
DOI:
10.13389/j.cnki.rao.2021.0163
文献标志码:
A
摘要:
目的 探讨水液缺乏型干眼和混合型干眼患者睑板腺形态及功能差异。方法 选取四川大学华西医院2018年9月至12月眼科门诊收治的干眼患者67例(67眼),其中水液缺乏型干眼患者32例32眼(水液缺乏型组),混合型干眼患者35例35眼(混合型组)。分别统计两组患者眼表疾病指数问卷调查表得分,采用LipiViewⅡ眼表面干涉仪测量患者泪膜脂质层厚度、不完全瞬目比例,拍摄并记录两组患者上、下睑睑板腺缺失率(MGDR),并进行睑板腺缺失严重程度的评估,检测或记录患者泪膜破裂时间、角膜荧光素染色(FL)评分、泪液分泌试验。结果 水液缺乏型组和混合型组患者眼表疾病指数评分分别为(26.59±17.16)分和(29.31±15.77)分,差异无统计学意义(t=0.676,P=0.501)。水液缺乏型组患者上睑MGDR和FL评分均高于混合型组患者,差异均有统计学意义(均为P<0.05);两组患者泪膜脂质层厚度、不完全瞬目比例、下睑MGDR、泪膜破裂时间、泪液分泌试验结果相比,差异均无统计学意义(均为P>0.05)。水液缺乏型组患者上睑睑板腺缺失严重程度分级较混合型组增高(P<0.05),下睑睑板腺缺失严重程度分级两组差异无统计学意义(P>0.05)。水液缺乏型组患者上、下睑MGDR与FL评分均无相关性(r=0.281,P=0.119;r=0.012,P=0.947)。混合型组上睑MGDR与FL评分呈正相关性(r=0.399,P=0.018),下睑MGDR与FL评分无相关性(r=0.077,P=0.660)。结论 水液缺乏型干眼患者存在睑板腺缺失和萎缩,较混合型干眼患者上睑睑板腺萎缩更严重,角膜损伤更加明显。
Abstract:
Objective To investigate the morphologic and functional differences of meibomian gland in patients with aqueous-deficient dry eyes (ADDE) and mixed dry eyes. Methods A total of 67 patients (67 eyes) with dry eyes diagnosed at the West China Hospital of Sichuan University from September to December 2018 were selected in this study, including 32 patients (32 eyes) with aqueous-deficient dry eyes (ADDE group) and 35 patients (35 eyes) with mixed dry eyes (mixed group). Each group’s ocular surface disease index (OSDI) score was recorded. LipiView II was used to measure the lipid layer thickness (LLT) and partial blink rate (PBR). The meibomian gland dropout rate (MGDR) of the upper and lower eyelids was recorded and assessed. The tear film breakup time (BUT), corneal fluorescence staining (FL) score and Schimer I test (SIt) were detected or recorded.Results The OSDI scores of the ADDE group and mixed group were 26.59±17.16 and 29.31±15.77, respectively, and the difference between the two groups had no statistical significance (t=0.676, P=0.501). The upper eyelid MGDR and FL scores of the ADDE group were higher than those of the mixed group, with the difference being statistically significant (P<0.05). There were no significant differences in the LLT, PBR, lower eyelid MGDR, tear film BUT and SIt between the two groups (all P>0.05). The upper eyelid MGDR in the ADDE group was higher than that in the mixed group (P<0.05), while the lower eyelid MGDR in the two groups showed no statically significant difference (P>0.05). Both of the upper and lower eyelid MGDR in the ADDE group were not correlated with the FL score (r=0.281, P=0.119; r=0.012, P=0.947). In the mixed group, the upper eyelid MGDR was positively correlated with the FL score (r=0.399, P=0.018), and the lower eyelid MGDR had no correlation with the FL score (r=0.077, P=0.660).Conclusion Patients with ADDE are more likely to suffer meibomian gland loss and atrophy, and their upper eyelid meibomian gland atrophy and corneal damage are more serious than patients with mixed dry eyes.

参考文献/References:

[1] 中华医学会眼科学分会角膜病学组.干眼临床诊疗专家共识(2013年)[J].中华眼科杂志,2013,49(1):73-75.
Chinese Medical Association,Chinese Society of Ophthalmology,Corneal Department.Expert consensus of clinical diagnosis and treatment for dry eye(2013)[J].Chin J Ophthalmol,2013,49(1):73-75.
[2] CRAIG J P,NICHOLS K K,AKPEK E K,CAFFERY B,DUA H S,JOO C K,et al.TFOS DEWS II definition and classification report[J].Ocul Surf,2017,15(3):276-283.
[3] STAPLETON F,ALVES M,BUNYA V Y,JALBERT I,LEKHANONT K,MALET F,et al.TFOS DEWS II epidemiology report[J].Ocul Surf,2017,15(3):334-365.
[4] KELLY K N,GARY N F,ANTHONY J B,BEN J G,MURAT D,KAZUO T,et al.The international workshop on meibomian gland dysfunction:executive summary[J].Invest Ophthalmol Vis Sci,2011,52(4):1922-1929.
[5] 刘祖国.干眼的诊断[J].中华眼科杂志,2002,38(5):318-320.
LIU Z G.Diagnosis of dry eye[J].Chin J Ophthalmol,2002,38(5):318-320.
[6] ARITA R,ITOH K,INOUE K,AMANO S.Noncontact infrared meibography to document age-related changes of the meibomian glands in a normal population[J].Ophthalmology,2008,115(5):911-915.
[7] ZHANG M,CHEN J,LUO L,XIAO Q,SUN M,LIU Z.Altered corneal nerves in aqueous tear defieieney viewed by in vivo eonfocal microscopy[J].Cornea,2005,24(7):818-824.
[8] ZANG S,CUI Y,CUI Y,FEI W L.Meibomian gland dropout in Sjgren’s syndrome and non-Sjgren’s dry eye patients[J].Eye,2018,32(11):1681-1687.
[9] MENZIES K L,SRINIVASAN S,PROKOPICH C L,JONES L.Infrared imaging of meibomian glands and evaluation of the lipid layer in Sjgren’s syndrome patients and nondry eye controls[J].Invest Ophthalmol Vis Sci,2015,56(2):836-841.
[10] KANG Y S,LEE H S,LI Y,CHOI W,YOON K C.Manifestation of meibomian gland dysfunction in patients with Sjgren’s syndrome,non-Sjgren’s dry eye,and non-dry eye controls[J].Int Ophthalmol,2018,38(3):1161-1167.
[11] NORN M S.Vital staining of the canaliculus lacrimalis and the palpebral border (Marx’ line)[J].Acta Ophthalmol,1966,44(6):948-959.
[12] LIU H,BEGLEY C,CHEN M,BRADLEY A,BONANNO J,MCNAMARA N A,et al.A link between tear instability and hyperosmolarity in dry eye[J].Invest Ophthalmol Vis Sci,2009,50(8):3671-3679.
[13] SULLIVAN D A,WICKHAM L A,ROCHA E M,KRENZER K L,SULLIVAN B D,STEAGALL R,et al.Androgens and dry eye in Sjgren’s syndrome[J].Ann N Y Acad Sci,1999,876:312-324.
[14] SULLIVAN D A,SCHAUMBERG D A,SUZUKI T,SCHIRRA F,LIU M,RICHARD S,et al.Sex steroids,meibomian gland dysfunction and evaporative dry eye in Sjgren’s syndrome[J].Lupus,2002,11(10):667.
[15] FOULKS G N,FORSTOT S L,DONSHIK P C,FORSTOT J Z,GOLDSTEIN M H,LEMP M A,et al.Clinical guidelines for management of dry eye associated with Sjgren disease[J].Ocul Surf,2015,13(2):118-132.

相似文献/References:

[1]皮百木 穆红梅 张婉婷 郑娜 李娟.老年干眼患者眼表改变及其与睑板腺功能障碍的相关性[J].眼科新进展,2013,33(6):000.
[2]谭业双 周霞 许 玲 王玲丽 樊玲.抗炎治疗睑板腺功能障碍的临床研究[J].眼科新进展,2012,32(1):000.
[3]杨帆,曾庆延.睑板腺功能障碍治疗进展[J].眼科新进展,2016,36(10):996.[doi:10.13389/j.cnki.rao.2016.0267]
 YANG Fan,ZENG Qing-Yan.Research progress on treatment of meibomian gland dysfunction[J].Recent Advances in Ophthalmology,2016,36(8):996.[doi:10.13389/j.cnki.rao.2016.0267]
[4]李妍,桑璇,王晓然,等.干眼患者泪膜脂质层厚度检测及其与眼表体征的相关性分析[J].眼科新进展,2017,37(4):344.[doi:10.13389/j.cnki.rao.2017.0087]
 LI Yan,SANG Xuan,WANG Xiao-Ran,et al.Measurement of tear film lipid layer thickness in dry eye patients and its relationship with ocular surface signs[J].Recent Advances in Ophthalmology,2017,37(8):344.[doi:10.13389/j.cnki.rao.2017.0087]
[5]余婷,叶芬,施宇华,等.睑板腺功能障碍患者的视觉质量分析[J].眼科新进展,2017,37(10):966.[doi:10.13389/j.cnki.rao.2017.0245]
 YU Ting,YE Fen,SHI Yu-Hua,et al.Evaluation of visual quality in patients with meibomian gland dysfunction[J].Recent Advances in Ophthalmology,2017,37(8):966.[doi:10.13389/j.cnki.rao.2017.0245]
[6]袁媛.干眼危险因素的研究[J].眼科新进展,2017,37(12):1173.[doi:10.13389/j.cnki.rao.2017.0296]
 YUAN Yuan.Risk factors for dry eye[J].Recent Advances in Ophthalmology,2017,37(8):1173.[doi:10.13389/j.cnki.rao.2017.0296]
[7]石文卿,孙铁,朱佩文,等.老年性睑板腺功能障碍患者下睑内翻的两种术式疗效对比[J].眼科新进展,2018,38(11):1041.[doi:10.13389/j.cnki.rao.2018.0245]
 SHI Wen-Qing,SUN Tie,ZHU Pei-Wen,et al.Analysis of the effect of two surgical correction methods for lower eyelid entropion in patients with meibomian gland dysfunction[J].Recent Advances in Ophthalmology,2018,38(8):1041.[doi:10.13389/j.cnki.rao.2018.0245]
[8]李勇,杜婧,李晶,等.不同频率强脉冲光联合睑板腺按摩治疗睑板腺功能障碍导致的干眼症患者的临床疗效[J].眼科新进展,2020,40(12):1152.[doi:10.13389/j.cnki.rao.2020.0256]
 LI Yong,DU Jing,LI Jing,et al.Clinical effect analysis of different frequencies on intense pulsed light combined with meibomian gland massage for meibomian gland dysfunction associated with dry eye[J].Recent Advances in Ophthalmology,2020,40(8):1152.[doi:10.13389/j.cnki.rao.2020.0256]
[9]熊超,赖瑶,艾丽珍,等.红外线照相技术联合活体共聚焦显微镜对轻度睑板腺功能障碍患者早期诊断价值的研究[J].眼科新进展,2021,41(1):069.[doi:10.13389/j.cnki.rao.2021.0015]
 XIONG Chao,LAI Yao,AI Lizhen,et al.The value of infrared photography combined with in vivo confocal microscopy in the early diagnosis of patients with mild meibomian gland dysfunction[J].Recent Advances in Ophthalmology,2021,41(8):069.[doi:10.13389/j.cnki.rao.2021.0015]
[10]曹宇辰,张杰鑫,黎颖莉,等.有无睑板腺功能障碍患者眼表菌群组成对比[J].眼科新进展,2021,41(12):1138.[doi:10.13389/j.cnki.rao.2021.0238]
 CAO Yuchen,ZHANG Jiexin,LI Yingli,et al.Comparison of ocular surface microbial colonies between patients with and without meibomian gland dysfunction[J].Recent Advances in Ophthalmology,2021,41(8):1138.[doi:10.13389/j.cnki.rao.2021.0238]

备注/Memo

备注/Memo:
四川省科技厅重点研发项目(编号:2021YFS0221)
更新日期/Last Update: 2021-08-05